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Purpose: To assess prospectively long-term results of doxorubicin-loaded HepaSphere 30–60 μm in consecutive patients with hepatocellular carcinoma (HCC) not amenable to curative treatments. Patients and Methods: Single-center study from June 2011 to December 2015 in 151 patients treated with 75 mg of doxorubicin per HepaSphere vial. Baseline: Barcelona Clinic Liver Cancer BCLC A/B was 49.3%/50.7%, and median diameter 6.1 cm (mean 6.7 ± 2.0). Liver function, local response (mRECIST), liver time to progression (LTTP), progression-free survival (PFS), overall survival (OS) and adverse events (AEs) were recorded. Results: Final analysis included 142 patients with median follow-up of 46.8 months (range 4–72) without grade 4/5 AEs, and 30-day mortality was 0%. Mean number of scheduled treatments was 2.6 (range 1–3) and on demand 3 (range 1–8). Complete response for single tumor ≤ 5 cm was 75.0% and 66.7% for Child A and Child B, while for > 5 cm was 28.6% and 11.8%, respectively. OS was 31.0 months (mean 33.3 ± 15.2; range 8–69), notably for BCLC A 41 months (mean 41.1 ± 15.3; range 13–69) and for BCLC B 26.0 (mean 26.0 ± 10.5; range 8–51). OS at 1, 3 and 5 years: 95.8%, 75.7% and 21.4% for BCLC A, and 94.4%, 36.1% and 2.7% for BCLC B. Median LTTP for BCLC A was 11 months (mean 11.9 ± 4.7; range 3–24) and 7.5 for BCLC B (mean 7.9 ± 2.9). Local response was significant for OS and LTTP (p < 0.0001), while size and lesion number affected LPFS and OS (p < 0.001). Conclusions: HepaSphere 30–60 μm loaded with doxorubicin provides a safe and effective treatment option for patients with HCC. © 2019, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE). |
